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Ventricular tachycardia in two patients with AIDS receiving ganciclovir (DHPG)
Insights
Ganciclovir, an antiviral medication, may trigger ventricular tachycardia in some patients. Recurrence of ventricular tachycardia was observed upon re-administration of ganciclovir, suggesting a potential link.
Area of Science:
- Pharmacology
- Cardiology
- Virology
Background:
- Ganciclovir (9-(1,3-dihydroxy-2-propoxy)methylguanine, DHPG) is a crucial antiviral agent for cytomegalovirus (CMV) infections.
- Cardiac arrhythmias are a potential concern in patients with severe infections and those receiving intensive medical treatment.
Observation:
- Two patients receiving intravenous ganciclovir developed ventricular tachycardia.
- In one patient, ventricular tachycardia recurred upon re-initiation of ganciclovir therapy for a worsening CMV infection, despite cardiac monitoring.
Findings:
- A strong temporal association was noted between ganciclovir administration and the onset of ventricular tachycardia.
- No other predisposing factors for arrhythmias were identified in these cases, suggesting ganciclovir as a potential causative agent.
Implications:
- These cases highlight a potential cardiotoxic effect of ganciclovir, specifically the induction of ventricular tachycardia.
- Clinicians should consider ganciclovir as a potential contributor to arrhythmias in susceptible patients, especially those with CMV infections.
Abstract:
We report two cases of patients who developed ventricular tachycardia while receiving intravenous infusions of ganciclovir [9-(1,3-dihydroxy-2-propoxy)methylguanine, DHPG]. Worsening cytomegalovirus infection prompted renewal of ganciclovir therapy under close cardiac monitoring in one of these patients, and ventricular tachycardia recurred. The close temporal relationship between administration of the drug and onset of the arrhythmias in conjunction with the absence of other factors known to predispose to arrhythmias suggest that ganciclovir may have played a role in the development of arrhythmias in these patients. The clinical courses of the patients are discussed, as are autopsy results.